Today was my first physical therapy (PT) and it was pretty uneventful. It was a little disheartening when the therapist made it quite obvious he didn't read my file thoroughly. First thing he said to me was "When did you break your leg?"
To which I responded, "Um, I didn't."
"Oh, I thought it said you had a minor leg fracture..."
So I had to explain to this guy, this guy who went to school for what he does what I just had done. Whatever, I'll try not to read too much into it, perhaps he was just having an off day.
He measured my ROM, I'm not positive what the exact number was but I think it was about 40 degrees (pathetic I know). Then he gave me a list of home exercises to work on:
Knee bends
Ankle alphabet
Quad squeezes
Assisted leg lifts
Heel slides
(20-30 times each, 3 times a day)
I didn't realize how weak my quad has become, even with my being able to bear weight. I've got quite a ways to go.
Thursday, June 26, 2014
Tuesday, June 17, 2014
Physical Therapy Session #1 is Finally Scheduled
After several phone calls, I finally got my Physical Therapy referral taken care of. It's crazy how difficult they made it considering the rehab center is in the same building as my doctor's office.
Anywho, my first session will be on June 26th. I'm trying not to focus on the fact that it has been nearly a month and I have yet to regain any sort of ROM. I was not given a CPM machine so I've been resting my leg on a towel placed on the floor and trying to gently slide it back and forth to get some blood pumping. However, I have only managed to get to about 30 degrees... on a good day. I am a little worried to do more as I do not want to do anything to hinder the development of my fake cartilage. Perhaps I would be just fine doing a little more but... I'm not the one with a medical degree.
I've been doing relatively well the last couple of weeks. I have my days where my knee just aches and others where all of the muscles in my leg feel non-existent. I still try to use my ice machine on a daily basis but some days I am forced to take a break from it. Whenever I ice and I wish to disconnect for a few minutes whether it is for a bathroom break, to let the dogs out, etc. I have to use my crutches as I am still not able to put any weight on my right leg unless I am strapped into my locked brace (I'll tell you about my sweet crutches here in a bit). So I try to get everything done around the house before I settle down to ice because once I do, I am down for the count.
I ran out of pain medication about a week ago so I have only been taking Tylenol twice a day (once when I lay down at night and again in the morning to relieve that stiff achey-ness). The first couple of days were a little rough as my pain has become so sporadic. But my body adjusted just fine... or maybe my pain tolerance has just increased, who knows?
Okay, so back to my crutches. I have been on crutches several times so I am familiar with the correct way to fit them and whatnot but sometimes crutches just hurt. For anyone that is facing a significant amount of time on crutches, can I give you one piece of advice? CRUTCHEZE! They don't make crutches enjoyable but they certainly make them a little less awful.
Anywho, my first session will be on June 26th. I'm trying not to focus on the fact that it has been nearly a month and I have yet to regain any sort of ROM. I was not given a CPM machine so I've been resting my leg on a towel placed on the floor and trying to gently slide it back and forth to get some blood pumping. However, I have only managed to get to about 30 degrees... on a good day. I am a little worried to do more as I do not want to do anything to hinder the development of my fake cartilage. Perhaps I would be just fine doing a little more but... I'm not the one with a medical degree.
I've been doing relatively well the last couple of weeks. I have my days where my knee just aches and others where all of the muscles in my leg feel non-existent. I still try to use my ice machine on a daily basis but some days I am forced to take a break from it. Whenever I ice and I wish to disconnect for a few minutes whether it is for a bathroom break, to let the dogs out, etc. I have to use my crutches as I am still not able to put any weight on my right leg unless I am strapped into my locked brace (I'll tell you about my sweet crutches here in a bit). So I try to get everything done around the house before I settle down to ice because once I do, I am down for the count.
I ran out of pain medication about a week ago so I have only been taking Tylenol twice a day (once when I lay down at night and again in the morning to relieve that stiff achey-ness). The first couple of days were a little rough as my pain has become so sporadic. But my body adjusted just fine... or maybe my pain tolerance has just increased, who knows?
Okay, so back to my crutches. I have been on crutches several times so I am familiar with the correct way to fit them and whatnot but sometimes crutches just hurt. For anyone that is facing a significant amount of time on crutches, can I give you one piece of advice? CRUTCHEZE! They don't make crutches enjoyable but they certainly make them a little less awful.
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| So long boring ugly crutches!! |
Monday, June 16, 2014
Options, Options
As I mentioned before, my Orthopedic surgeon, Dr. O'Daniel told me that there are most likely two options to solve my knee issues. Drumroll, please...
1. Autogenous Cartilage Implantation (ACI) - Where cells are extracted during an arthroscopic procedure and sent to a lab where cartilage is grown. Then, during a more invasive procedure, the cells are injected under a periosteal flap.
2. Osteochondral Autograft Transfer System (OATS) - Plugs of healthy cartilage and bone are taken from a healthy area and moved to replace the damaged cartilage area of the knee. It is my understanding that these plugs can also be taken from a cadaver.
Dr. O'Daniel seems to truly understand my frustrations which, in my little experience, is very rare in a doctor. He understands although I am not in constant chronic pain (thank goodness), I am only 23 and these are not issues that are going to heal themselves--cartilage does not grow back. He understands that eventually my husband and I are going to want to start a family and how I am supposed to keep up with a child if I can hardly climb out the car without very audible and painful knee cracking?
Anyway, he told me he would do research on specialists in the area and get back to me with a referral.
Also, I was supposed to start physical therapy right after my 1st follow-up appointment (June 9th) but I am still trying to get everything set up... it's a long story so I will not bore you with it.
1. Autogenous Cartilage Implantation (ACI) - Where cells are extracted during an arthroscopic procedure and sent to a lab where cartilage is grown. Then, during a more invasive procedure, the cells are injected under a periosteal flap.
2. Osteochondral Autograft Transfer System (OATS) - Plugs of healthy cartilage and bone are taken from a healthy area and moved to replace the damaged cartilage area of the knee. It is my understanding that these plugs can also be taken from a cadaver.
Dr. O'Daniel seems to truly understand my frustrations which, in my little experience, is very rare in a doctor. He understands although I am not in constant chronic pain (thank goodness), I am only 23 and these are not issues that are going to heal themselves--cartilage does not grow back. He understands that eventually my husband and I are going to want to start a family and how I am supposed to keep up with a child if I can hardly climb out the car without very audible and painful knee cracking?
Anyway, he told me he would do research on specialists in the area and get back to me with a referral.
Also, I was supposed to start physical therapy right after my 1st follow-up appointment (June 9th) but I am still trying to get everything set up... it's a long story so I will not bore you with it.
Wednesday, June 11, 2014
1st Follow-Up Appointment
I had my first follow-up appointment on June 9th, 11 days after my Microfracture surgery.
The office was running a little behind schedule so I had to wait awhile which normally doesn't bother me but considering there was nowhere for me to prop my leg up, my knee started throbbing pretty quickly and I was, to say the least, extremely uncomfortable. Luckily they called me back right as I was wishing I had thought to bring my pain medication with me.
When the doctor first came in he was carrying a stack of papers, which I thought was odd. But he sat down and asked me how I was doing, how my knee was doing, blah blah blah. I told him I was doing better than I expected. At this point, the swelling had finally began to subside and I was getting a little range of motion (ROM) back. Key word: LITTLE. He didn't seem too worried about it since he wanted me to start physical therapy soon anyway.
Next, he broke out that previously mentioned stack of papers which included a bunch of pictures he took during surgery. He walked me through each of them, showed me that my ACL and MCL looked great. Looking back, I can see he was trying to build me up before he tore me down (not intentionally, of course--he can't help that I have the knees of a 90 year old). Then he showed me all of the loose bodies that were floating around my knee. Not only were there little pieces of cartilage like he expected, there are also pieces of bone. I was trying so hard to listen to what he was saying I didn't think to bring a piece of paper to write everything down (or perhaps I should have recorded him or something).
There were several areas where my cartilage resembled crabmeat. There were signs of arthritis in the tibial spine, trochlea and medial condyle. Also, there was syngvitis laterally (no idea what that is but I will consult my friend Google here pretty soon). And more importantly, there was complete cartilage loss on the lateral condyle as well as the medial femoral condyle.
***Sidebar: More of a note to myself than to you but lateral = outside of knee and medial = inside. Femoral = upper and tibial = lower... I think. Please correct me if I am wrong, I am still getting used to all of this medical terminology. I am expecting to speak fluent "doctor" before the end of the year.***
Dr. O'Daniel performed the Microfracture on the lateral condyle, where the cartilage loss was the most significant, however, he is less than confident that the procedure will take and here is why. In order for a Microfracture to work, there must be clean margins. These margins help to hold that "superscab" in place and without them, there is a very high chance that it will not form and even if it does, it will most likely not remain in place.
Anyway, Dr. O'Daniel did say that the surgery was not a complete waste. If anything, the removal of all of that floating junk will provide me with some minor relief. There are additional options for me, however, he did not feel comfortable performing (at least he wasn't too proud to admit that).
More on this later... this post is getting really long. SORRY!!
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| Waiting for the doctor at my first follow-up appointment |
The office was running a little behind schedule so I had to wait awhile which normally doesn't bother me but considering there was nowhere for me to prop my leg up, my knee started throbbing pretty quickly and I was, to say the least, extremely uncomfortable. Luckily they called me back right as I was wishing I had thought to bring my pain medication with me.
When the doctor first came in he was carrying a stack of papers, which I thought was odd. But he sat down and asked me how I was doing, how my knee was doing, blah blah blah. I told him I was doing better than I expected. At this point, the swelling had finally began to subside and I was getting a little range of motion (ROM) back. Key word: LITTLE. He didn't seem too worried about it since he wanted me to start physical therapy soon anyway.
Next, he broke out that previously mentioned stack of papers which included a bunch of pictures he took during surgery. He walked me through each of them, showed me that my ACL and MCL looked great. Looking back, I can see he was trying to build me up before he tore me down (not intentionally, of course--he can't help that I have the knees of a 90 year old). Then he showed me all of the loose bodies that were floating around my knee. Not only were there little pieces of cartilage like he expected, there are also pieces of bone. I was trying so hard to listen to what he was saying I didn't think to bring a piece of paper to write everything down (or perhaps I should have recorded him or something).
There were several areas where my cartilage resembled crabmeat. There were signs of arthritis in the tibial spine, trochlea and medial condyle. Also, there was syngvitis laterally (no idea what that is but I will consult my friend Google here pretty soon). And more importantly, there was complete cartilage loss on the lateral condyle as well as the medial femoral condyle.
 |
 |
 |
***Sidebar: More of a note to myself than to you but lateral = outside of knee and medial = inside. Femoral = upper and tibial = lower... I think. Please correct me if I am wrong, I am still getting used to all of this medical terminology. I am expecting to speak fluent "doctor" before the end of the year.***
Dr. O'Daniel performed the Microfracture on the lateral condyle, where the cartilage loss was the most significant, however, he is less than confident that the procedure will take and here is why. In order for a Microfracture to work, there must be clean margins. These margins help to hold that "superscab" in place and without them, there is a very high chance that it will not form and even if it does, it will most likely not remain in place.
Anyway, Dr. O'Daniel did say that the surgery was not a complete waste. If anything, the removal of all of that floating junk will provide me with some minor relief. There are additional options for me, however, he did not feel comfortable performing (at least he wasn't too proud to admit that).
More on this later... this post is getting really long. SORRY!!
Thursday, June 5, 2014
1 Week Post-Op
This past week has been a roller coaster. I spend the majority of my time sitting on the couch hooked up to my IceMan. For those who are not familiar with this amazing contraption it looks like a cooler (you know, the ones you try to stuff as many 'beverages' in when you go fishing) and has a hose coming from the front of it. You fill it up with ice and then water. Then you hook it up to this little pad you secure to your knee with these things that resemble heavy-duty ace bandages. There are two hoses that are meant to circulate ice cold water in and out of the cooling pad. For the first couple of days I didn't get much relief from this impressive hunk of machine because I was still sporting my relatively thick surgical dressing.
Day 3 was a rough day. I started the day by popping an extra pain pill and telling my husband I wanted to take a shower (I'm sure he was relieved). I was a little worried about removing the compression dressing especially when I saw the amount of blood the cotton had absorbed. My knee looked disgusting (picture to follow). There was minimal bruising but it was super swollen (which was expected). Getting in and out of the shower was difficult. We have a tub with sliding glass doors so it was really hard to get in and out without bending or putting weight on my right leg, especially considering hopping around resulted in blinding pain. Eventually I learned that by leaning on the wall and just kind of scooting/inching my left foot around slowly I could function on my own. I'm sorry if that was a bad description, I can't think of any other way to describe my odd shower technique.
My post-op instructions said I could get my leg wet but to only let the water and soap run over it--no scrubbing. This was not a hard instruction to follow as even the slightest brush against my disgusting knee hurt. I stayed in the shower as long as I could before forcing myself to get out. By the time I was dry and dressed again I was ready to plop back down on the couch. I redressed my knee using non-stick pads, a roll of gauze and topping it off with my ace bandage. I wanted to keep the dressing as thin as possible (so I could feel the ice a little more) while still providing a layer of cushion. Finally I laid back down and my Boston Terrier finally gave in to my pleading and cuddled up next to me (probably because I didn't smell like a hospital anymore).
As exhausted and uncomfortable as I was I was instantly met with reward when I reattached myself to the IceMan. I could feel the cold! Relief was practically instantaneous.
I don't know if I mentioned it before, but I have been sleeping hooked up to my ice machine and I suggest, if you are ever in the same position as me, to do the same. A relatively numb and pain free knee makes for falling asleep much easier. The only thing that stinks is when you wake up in the middle of the night only to realize that the once cold pad is now luke warm. This is normally when I take another pain pill, try my best to sit up, and start perusing the newest threads on Chive or continue rereading the Harry Potter books for the millionth time (I'm a nerd and proud). Also, STOCK UP ON ICE!!!! And I'm not talking about buying a little dinky 10 pound bag, I'm talking about buying as much as you can find space for. You will go through it a lot faster than you think.
Overall, a difficult week but not as bad as I was expecting. I can get around alright and my husband has been more than helpful. Patience, patience and more patience.
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| IceMan... my new best friend |
Day 3 was a rough day. I started the day by popping an extra pain pill and telling my husband I wanted to take a shower (I'm sure he was relieved). I was a little worried about removing the compression dressing especially when I saw the amount of blood the cotton had absorbed. My knee looked disgusting (picture to follow). There was minimal bruising but it was super swollen (which was expected). Getting in and out of the shower was difficult. We have a tub with sliding glass doors so it was really hard to get in and out without bending or putting weight on my right leg, especially considering hopping around resulted in blinding pain. Eventually I learned that by leaning on the wall and just kind of scooting/inching my left foot around slowly I could function on my own. I'm sorry if that was a bad description, I can't think of any other way to describe my odd shower technique.
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| 3 days post-op |
My post-op instructions said I could get my leg wet but to only let the water and soap run over it--no scrubbing. This was not a hard instruction to follow as even the slightest brush against my disgusting knee hurt. I stayed in the shower as long as I could before forcing myself to get out. By the time I was dry and dressed again I was ready to plop back down on the couch. I redressed my knee using non-stick pads, a roll of gauze and topping it off with my ace bandage. I wanted to keep the dressing as thin as possible (so I could feel the ice a little more) while still providing a layer of cushion. Finally I laid back down and my Boston Terrier finally gave in to my pleading and cuddled up next to me (probably because I didn't smell like a hospital anymore).
As exhausted and uncomfortable as I was I was instantly met with reward when I reattached myself to the IceMan. I could feel the cold! Relief was practically instantaneous.
I don't know if I mentioned it before, but I have been sleeping hooked up to my ice machine and I suggest, if you are ever in the same position as me, to do the same. A relatively numb and pain free knee makes for falling asleep much easier. The only thing that stinks is when you wake up in the middle of the night only to realize that the once cold pad is now luke warm. This is normally when I take another pain pill, try my best to sit up, and start perusing the newest threads on Chive or continue rereading the Harry Potter books for the millionth time (I'm a nerd and proud). Also, STOCK UP ON ICE!!!! And I'm not talking about buying a little dinky 10 pound bag, I'm talking about buying as much as you can find space for. You will go through it a lot faster than you think.
Overall, a difficult week but not as bad as I was expecting. I can get around alright and my husband has been more than helpful. Patience, patience and more patience.
Saturday, May 31, 2014
Surgery, Take 2
As soon as I woke up on Thursday, May 29th, I was worried. Not only worried about the surgery and recovery but also that it would be postponed again. It's not that I was in such an amount of pain that I couldn't take waiting a few more days again, it's just that the waiting is such a pain.
I was given packets of Hibicleans and for those of you that have not experienced the pain in the arse that comes with using it, let me break it down for you : You start by showering and doing your normal thing. Then you have to turn off the water and pour this nasty smelling pink liquid on the part of your body that is being operated on (in this case, my right knee). Then set your timer. I was told I had to keep rubbing it in for 5 minutes and then rinse, repeat and pat dry. I had to do this before bed and again when I was getting ready in the morning in order to prevent infection. I know it doesn't sound like much but this little process was so annoying and if my surgery was postponed again and I had to endure that hell once more I probably would have screamed.
Luckily they were able to get my in the operating room that day (they were even a little ahead of schedule--surprise!!).
I was given packets of Hibicleans and for those of you that have not experienced the pain in the arse that comes with using it, let me break it down for you : You start by showering and doing your normal thing. Then you have to turn off the water and pour this nasty smelling pink liquid on the part of your body that is being operated on (in this case, my right knee). Then set your timer. I was told I had to keep rubbing it in for 5 minutes and then rinse, repeat and pat dry. I had to do this before bed and again when I was getting ready in the morning in order to prevent infection. I know it doesn't sound like much but this little process was so annoying and if my surgery was postponed again and I had to endure that hell once more I probably would have screamed.
Luckily they were able to get my in the operating room that day (they were even a little ahead of schedule--surprise!!).
What happened immediately before and after the surgery is sort of a blur. My nurse wrapped me in warm blanket and carted me off to the operating room where I was told to scoot onto this really small (and cold) table. Then she told me to outstretch my arms and proceeded to strap them down. The anesthesiologist caught me off guard as she began to stick cold pads and sensors onto my chest. Someone must have slipped me something because next thing I knew I was half awake in the recovery room swaddled in these super warm blankets. I must have still been out of it because I kept dozing off. Then I woke up in my room (I think my husband was there too, I can't remember) and my ice machine was hooked up.
The doc came in to talk with me about the surgery. I wish he would have written everything down for me because I can hardly remember what he said. What I do remember him mentioning was that he removed a lot of debris that was floating around. He said he did manage to complete the microfracture, however, he was not confident that the procedure would take due to the location. I didn't understand what this meant at the time so I will fill you in on what he meant when I talk about my first follow-up appt.
What really caught me off-guard was that he was changing his weight bearing orders. In case you don't remember, Dr. O'Daniel (have I mentioned his name before?) said that I would be completely non-weight bearing (NWB) and in a locked range of motion (ROM) post-op brace for at least 6-8 weeks. Now all of a sudden he was saying I could immediately put full weight on that leg as long as my brace is locked at zero degrees. Although I do not remember everything, I do remember that I got really freaked out when he said that I would have to "peg-leg it" for awhile. My instant thought was of a cartoon pirate with a wooden leg, I thought he was saying that I would need an amputation. Looking back , I know this makes absolutely no sense... it really upset me at the time, now I know that general anesthesia makes me a little weepy.
The drive home wasn't too bad as we only had about a 10 minute drive home and I was not in much pain at all. I sat in the back seat of the Volvo with my back against the driver side door and my right leg propped up on the seat beside me. I remember my husband was on the phone with his dad and I coughed. I have never had general anesthesia before so I was not expecting that awful and disgusting taste to all of a sudden overcome me. Of course, then I got this sudden wave of nausea forcing me to ask him to pull over. The wave passed and we continued home. I don't remember calling my mom after I posted my big booty on the couch but according to her Facebook status I called her and said that I was home and eating a Popsicle. I was in and out of a deep sleep for the next couple of hours, no serious pain just some sporadic feelings of nausea.
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| Taking a break from icing |
Wednesday, May 28, 2014
Surgery, Take 1
Although my surgeon had an opening within the next week, I decided to wait a few weeks to go under the knife. My husband is a Recruit Division Commander at Naval Station Great Lakes so he works with divisions of naval recruits. He works practically 17 hours a day 7 days a week for about 8 weeks. Every now and then he gets a few hours off but it definitely takes a toll on him as well as me. We don't have any family or many friends here so we needed to wait until his first division graduated so he was able to take some time off to be home with me. Also, because he has been so stressed out, we decided to take a little mini vacay!
Originally we wanted to rent a cabin in the Black Hills (South Dakota), but since it was Memorial Day weekend everything was either booked already or out of our price range so we decided upon Pigeon Forge, TN. We were a little disappointed by how touristy and overpriced the city was but we did get out of the cabin long enough to go on a wine tour, visit Gatlinburg, and even sample some real moonshine! Personally, I enjoyed the sassafras flavor (tasted like root beer) but Jon liked the Tennessee mud. Ultimately, I won and we bought a jar of the sassafras. Needless to say, it did not sit in our fridge very long. ;)
I have never noticed my veins. I have always been told that I have good veins for donating blood, the ones that are in my "elbow pit" are always easy to spot, however, apparently the ones in my hands are not. After 2 failed attempts the HM sent in a professional.
Sidebar: For those of you that are not familiar with what an HM is, it is a Hospital Corpsman. Although they go to school and receive training for whatever department they end up working in, they are not an actual Registered Nurse or anything like that so (I'm just assuming) that they do not have as much experience as the adorable old Filipino man that came and got my IV started immediately.
Anyway, then the doctor came in and drew some super pretty pictures on my knee and answered a couple of random questions I had thought of. Then they brought my husband back to my room where we sat and watched Identity Thief on the tube. Hours passed. Finally, around 2:30 or 3:00 the doctor came in and said that we would have to reschedule my procedure due to an emergency. Luckily he had an opening that Thursday so I would not have to wait long.
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